Survivin和Bax在髓母细胞瘤中的表达及其临床意义

目的探讨髓母细胞瘤（Medulloblastoma）中凋亡抑制蛋白（Survivin）和凋亡促进蛋白（Bax）的表达及临床意义。方法对50例髓母细胞瘤（观察组）及10例正常脑组织（对照组）石蜡切片行免疫组化检测,比较Survivin和Bax在两组中的表达差异,并应用相关统计分析方法对不同性别、年龄段、肿瘤大小、病理类型、临床分期的表达差异及其与预后的相关性进行分析。结果观察组中survivin蛋白阳性表达率为72%,明显高于对照组（P〈0.01）;亚组分析发现在survivin蛋白阳性组和阴性组病例中,性别分布、肿瘤部位、肿瘤大小、病理分型等因素在两者间无明显差异（P〉0.05）,而年龄及TM临床分期在两组间差异显著（P〈0.05）。bax蛋白在观察组中阳性表达率为22%,在对照组中的阳性表达率为20%（P〉0.05）;Bax阳性患者中在性别、年龄、肿瘤部位、肿瘤大小、病理类型等方面与Bax阴性患者相比无显著性差异（P〉0.05）,而两组的TM临床分期差异明显（P〈0.05）。Survivin阳性患者预后与阴性组相比差异显著（P〈0.05）,而Bax蛋白阴性患者和阳性组之间预后无差别（P〉0.05）。结论 Survivin和bax可能同时参与了对髓母细胞瘤细胞凋亡的调控,并对髓母细胞瘤的发生发展可能起着重要作用。Survivin与bax蛋白表达在髓母细胞瘤的发生发展中可能存在拮抗作用。由于survivin蛋白表达与髓母细胞瘤患者年龄、临床分期及预后等也密切相关,可作为判断病情和评价预后的指标。

Expression of survivin and bax in medulloblastoma and its clinical significance

Objective To examine the expression of apoptosis inhibitive protein（survivin） and pro-apoptosis protein（bax） in medulloblastoma,and investigate the relationship between the expression level of them and the clinical significance.Methods 50 cases of medulloblastoma and 10 cases of normal brain tissue were collected.Immuno-histochemistry assay was used to detect the expression of survivin and bax.We also compared the expression of them according to the sex,age,clinical stage,and size,pathological category of the tumor.The relationship between the expression and clinical prognosis was analyzed with corresponding statistical methods.Result Survivin protein was expressed in 36 cases of medulloblastoma（72%）,which remarked higher than that of the control（0%）.There were no differences of gender,position,size and pathological style of tumor between negative and positive of survivin protein groups（P0.05）.There were different effects of age and clinical stage between the two groups（P=0.044 and 0.027,respectively）.Bax positive rate were 22% and 20% of 50 medulloblastoma and 10 normal control（P=0.889）.There were no differences of gender,age,position,size and pathological style of tumor between negative and positive of survivin protein groups（P0.05）.There were different effects of age and clinical stage between the two groups（P=0.031）.The prognosis of survivin-positive patients was different from that of survivin-negative patients（P=0.001）.There was no difference of prognosis between the Bax-positive and Bax-negative groups.Conclusion Our data suggests that both of survivin and bax are involved in regulation of the apoptosis and cell cycle of medulloblastoma,which may play a crucial role in the genesis and progression of medulloblastoma.However,expression level of survivin is related to patient＇s age and the clinical stage,prognosis of medulloblastoma,and may influence the patients＇ condition and control the prognosis of medulloblastoma.